NPI | 1982117271 |
---|---|
Doing Business As | TRIAD OWEN SCHOOL BASED CLINIC |
Entity Type | Organization |
Authorized Contact | JESSICA WHEELER General Manager 859-567-1591 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2017-11-09 |
Last Update Date | 2018-03-17 |